Healthcare Provider Details

I. General information

NPI: 1407982135
Provider Name (Legal Business Name): PHILIP GARZA RODRIGUEZ F.N.P., D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N WATSON RD STE 166
ARLINGTON TX
76006-6223
US

IV. Provider business mailing address

PO BOX 80410
KELLER TX
76244-2906
US

V. Phone/Fax

Practice location:
  • Phone: 817-770-6867
  • Fax: 214-260-6062
Mailing address:
  • Phone: 817-770-6867
  • Fax: 214-260-6062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6478
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP129266
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: